Kratom advocates are cheering a new decision from the United Nations World Health Organization (WHO) not to recommend that the plant-derived substance be internationally banned following a scientific review.
There were some concerns that the WHO’s Executive Committee on Drug Dependency (ECDD) would take steps to either urge international control over kratom—which has been touted as a natural painkiller that works as a safer alternative to prescription opioids—or recommend a critical review that could have ultimately led to scheduling following another year-long inquiry.
“People report using kratom to self-medicate a variety of disorders and conditions, including pain, opioid withdrawal, opioid use disorder, anxiety and depression.”
But in a report released last week, members of ECDD voted 11-1 to simply continue monitoring data on the health impacts of kratom over the next two to three years, rather than institute strict controls. Members found “insufficient evidence” that kratom warrants a more in-depth critical review at this point.
WHO ECDD RECOMMENDS AGAINST CRITICAL REVIEW
“The Committee concluded that there is insufficient evidence to recommend a critical review of kratom.”
— American Kratom Association (@TheKratomAssn) December 7, 2021
While the decision was based on a scientific review of the risk of dependence, “abuse” potential and therapeutic applications of kratom, advocates also touted the fact that about 80,000 people submitted comments to the panel, sharing their perspectives and experiences with the plant-derived substance.
“People report using kratom to self-medicate a variety of disorders and conditions, including pain, opioid withdrawal, opioid use disorder, anxiety and depression,” ECDD said in its report. “Kratom is being used as a part of traditional medicine in some countries.”
“The Committee considered information regarding the traditional use and investigation into possible medical applications of kratom,” it continued. “The Committee concluded that there is insufficient evidence to recommend a critical review of kratom.”
Instead, the panel said it is recommending that kratom “be kept under surveillance by the WHO Secretariat,” as it has been since 2020.
Mac Haddow, senior fellow on public policy for the American Kratom Association (AKA), said that this is “all around a great outcome for science” that he hopes will translate into regulatory action within the US Food and Drug Administration (FDA) on kratom.
“The big problem with kratom today in the United States is a poorly regulated market because the FDA has been sitting on their hands,” he said, “and it empowers bad-actor kratom vendors to adulterate kratom products with dangerous substances like fentanyl, heroin and morphine.”
As it stands, kratom is not scheduled under the federal Controlled Substances Act or under international drug treaties to which the US is a party. The FDA has considered putting restrictions on the substance, but it has faced resistance and has been unable to do so at this point.
Some advocates suspected that, since the agency hasn’t imposed a ban on kratom domestically, it would use the WHO convention as an opportunity to get prohibition enacted internationally, a move that the country would be compelled to comply with.
Debate at the US Federal Level
A bipartisan and bicameral duo of congressional lawmakers sent a letter to the secretary of the US Department Health and Human Services and the country’s UN ambassador in October, imploring the officials to resist efforts to impose an international ban on kratom.
As federal agencies have gone back and forth about the merits of scheduling kratom over recent years, there’s been “no conclusive evidence that would warrant the United States voting in favor of an international control of this substance,” the lawmakers said.
Separately, the House Appropriations Committee approved a report to spending legislation over the summer that says federal health agencies have “contributed to the continued understanding of the health impacts of kratom, including its constituent compounds, mitragynine and 7-hydroxymitragynine.”
“The Committee is aware of the potential promising results of kratom for acute and chronic pain patients who seek safer alternatives to sometimes dangerously addictive and potentially deadly prescription opioids and of research investigating the use of kratom’s constituent compounds for opioid use disorder,” it said.
The panel also directed the Health and Human Services secretary to continue to refrain from recommending that kratom be controlled in Schedule I.
Late last year, the Agency for Healthcare Research and Quality (AHRQ) asked the public to help identify research that specifically looks at the risks and benefits of cannabinoids and kratom.
The Centers for Disease Control and Prevention (CDC) last year separately received more than 1,000 comments concerning kratom as part of another public solicitation.